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Contact Information

CHARLIE SRIVILASA, MD
10012 KENNERLY RD STE 406
SAINT LOUIS, MO63128-2197
 Phone: 314-525-1224
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgical Critical Care

2086S0102X 02 Physician/General Surgery
 

Surgery

208600000X 02 Physician/General Surgery
 

Trauma Surgery

2086S0127X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for CHARLIE SRIVILASA · (Male)

NPI Number 1346531464
Status Active
Credentials MD
Entity Individual
Enumeration date 04/23/2011
Last updated 05/24/2024 - About 2 years ago
Sole proprietor 1 No
Identifiers
  • MO License # 2018032445
  • MO Medicaid 200066167
Hospital affiliation(s)
  • BARNES JEWISH HOSPITAL - (Acute Care)
    ONE BARNES-JEWISH HOSPITAL PLAZA
    SAINT LOUIS, MO 63110
  • ST LOUIS UNIVERSITY HOSPITAL - (Acute Care)
    3635 VISTA AVE
    SAINT LOUIS, MO 63110
  • ST LUKES HOSPITAL - (Acute Care)
    232 S WOODS MILL RD
    CHESTERFIELD, MO 63017
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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